Monday 23 March 2020

COVID-19 Coronavirus UK and World News update 22-23 March

COVID-19 Coronavirus UK and World News update 22/23 March

A good statistical milestone today, as over 100,000 people have now recovered from COVID-19 worldwide. 101,554 in fact. Sadly though the total number of cases worldwide is 374,768. The number of people who have lost their lives worldwide to COVID-19 is now 16,355,

The UK has reported a total of 6,650 positive cases of COVID-19. We had in total tested 83,945 people as of 9am this morning. The UK now have a total of 335 losses of life.

Total cases are: England 5585, Scotland 499, Wales 418 and Northern Ireland 148. Already 135 of the UK's positive testing cases have recovered.

Rep. Of Ireland have 1125 cases and 6 losses of life.

"Life shouldn't feel normal right now, so if your life still feels entirely normal, ask yourself if you are doing the right things" Nicola Sturgeon.

Health Workers look after yourselves WHO

UK NEWS:

Today Boris held an emergency COBRA meeting and the press statement time was moved back twice, making everyone realise what was likely to be announced. We are on lockdown.

It's vital to reduce the spread of the disease. We've been asking people to stay at home, huge numbers are complying, but we need to do more.

You must stay at home except:
Infrequent shopping for basic necessities - food, medicine.
1 form of exercise a day
Any medical need
To provide care /help vulnerable
Travelling to work if it cannot be done from home.

No gatherings of more than 2 people who are not living together already as a group.

The police do have the powers to enforce compliance or disperse groups. Close all shops selling non-essential goods. Closing libraries, gyms, places of worship. All social events including weddings and baptisms cancelled. Parks are open for exercise, gatherings will be dispersed.
We will look at this again in THREE weeks.

At Sunday's press conference Boris stressed the importance of being 2m away from other people, especially anyone who isn't a member of your household. Everyone should follow this rule. Parks are not for playing together or congregating. Fresh air is great, inhaling someone else's COVID-19 infection, not great.
Everyone who is especially vulnerable now needs to isolate themselves from the rest of the community as best as possible. You'll receive a letter within days if this is you, and should isolate for 12 weeks from when you receive your letter. It includes distancing from the rest of your household as much as possible. Eat and sleep separately, all wash hands often. There is additional advice on the gov dot uk website. The army will be offering support to enable people to do this where they don't have family or friends who can support them.

People going for a last drink on Friday, the daytrippers on Saturday and some of you who went to see relatives today, alongside being behind with testing, will add up to the hundreds of thousands of cases as yet undiscovered. We know they exist, it's better to find out who they are. Most will start to show symptoms this week and infect their household, who will mostly be Ill next week and the one after. We are at the point our hospitals will within days become overwhelmed.

The National Trust have had to close all their gardens because so many of the UK public think this is a holiday. Remember when you studied the plague at school? That.

In a steady active outbreak cases will double roughly every 4 days. The UK are testing far more people now than before, so we might find it seems even quicker than that.

Some NHS staff are already taking to social media to complain about shortages of essential protective clothing. This is a massive problem worldwide and really puts staff, and in turn their families, at risk. Matt Hancock says a million masks have been bought and the army will be helping with distributing supplies.

The Government have announced a new Local Support System which will "make sure those individuals self-isolating at home and who are without a support network of friends and family will receive basic groceries. Community pharmacies will support those who need help getting their medicines delivered".

If you have a friend sitting in their holiday cottage feeling smug, please remind them that not only have they potentially taken the virus to a population who might have escaped it, but that their nearest hospital might usually only cater for a population of 14 and a donkey, and the local shop is likely to be the same.

The UK Government faced a bit of criticism over the Coronavirus Bill because it gave them powers for the next 2 years. They have said they will review it every 6 months.

McDonalds is closing all stores by 7pm tonight. They feel it's impossible to achieve social distancing in their buildings and are closing for the safety of staff and customers. All staff will retain their jobs during the closure. NANDO'S, Subway, Pret-A-Mange and Primark are among the huge number of other stores also closing.
(It is very likely they would have to close anything which isn't 'eat out' food very shortly anyway.)

I'm not usually in agreement with Piers Morgan, but today he has shared an image with the text "Confused about how far to distance yourself? Imagine the outline of a dead relative between you". Harsh, but judging by all the photos of crowds from around the UK, it has to be made very clear to some people.

The UK Government are offering funding of up to £25k to technology companies who come up with digital support solutions for people who need to stay at home because of coronavirus.

In Sunday's press conference Boris said "Stay at home. The more we comply, the faster we will beat it and the faster we will get through it."
I never thought I'd say this, but he's really not wrong.

WHO Childcare advce

Rest Of The World: 

Bolivia has postponed it's May elections and will go into national quarantine for 2 weeks starting today. They have reported 27 cases of COVID-19.

India have observed a self-imposed 14 hour curfew and at 5pm (noon gmt) today all came out onto their balconies and doorsteps to ring bells and bang drums, clap and make noise to thank essential service workers. India have reported 467 cases and 9 losses of life.

Spanish lockdown has the one person rule - you can only leave the house 1 at a time for essential trips. Only food, fuel and pharmacy are open. Fingers crossed it works. The Spanish Health Care system is, like Italy, collapsing under the weight of patients. Spain have reported 33,089 cases (+4,321 and 2,206 deaths (+434). They are in a very bad situation.

Pakistan has suspended all international flights. They have reported 873 cases and 6 losses of life.

Italy has extended it's lockdown. They lost 793 souls on Saturday and have been overwhelmed by cases for more than a week. When this happens medics have no choice but to decide who gets treatment and who doesn't.
Italian Prime Minister Guiseppe Conte said:
"These dead aren't numbers; they are people, families.... we have no alternative."
ALL non-essential businesses nationwide have to close, or work remotely. Only supermarkets, pharmacies, banks, post offices and financial services can stay open and travel is banned unless essential. Italy have reported 63,927 cases (+4,789) and 6,077 losses of life (+601). Their nightmare is not yet ending.

Nigeria has closed all airports and suspended international travel for 30 days. They have reported 36 cases of COVID-19 and lost 1 soul.

France has extended their lockdown. They have a 'one person' rule - one person can leave the house at any time. Citizens have been told they will be on lockdown for another 6 weeks. Army and police checkpoints exist at roundabouts and roads going into bigger towns. Penalties for unauthorised movement:1st time being caught €375 fine. 2nd time €1500... 3rd time, 6 months imprisonment. France have now reported 19,856 cases and 860 losses of life.

A plane arrived in Serbia on Saturday loaded with Chinese medical experts and over ten tons of medical supplies, including ventilators, masks and testing kits. Serbia have 249 cases and have lost 2 people to COVID-19.

Shortly after a lockdown was initiated in Croatia, Zagreb was hit by an earthquake (magnitude 5.5), forcing everyone to flee their homes. No loss of life has been reported, but there is a large amount of structural damage, including the top of the cathedral falling down. Croatia have 315 cases and have lost 1 person to COVID-19.

Taiwan has announced a ban on foreign air travellers from March 25th to April 7th. They're having a tiny blip in their almost perfect record, with a current total 195 cases and 2 losses of life.

Politico have created a live tracker for testing and positive cases in the US. The USA just moved to the third highest number of cases, behind China and Italy, and at this rate will very swiftly pass both of them. At time of this post going live they have 39,389 cases after adding over 21,000 in the last 36 hours, and have lost 467 people. New York has over 20,000 cases. (Link in sources below.)

Ohio has introduced social distancing rules for childcare, including a maximum of 6 children cared for in any single room.

German Chancellor Angela Merkel is now in quarantine after her doctor tested positive for COVID-19. Germany have imposed a ban on more than 2 people meeting together at any time, and any business which doesn't allow for a 1.5m space between people has to close for at least 2 weeks.

Singapore has banned all short-term visitors from entering the country. They have reported 509 cases and 2 losses of life.

Gaza has just reported its first 2 cases of COVID-19 imported from Pakistan. It has a virtually non-existent medical infrastructure and the population have already been under restrictions for 13 years. It is one of the most densely populated places on Earth. For COVID-19 to break into the community will be far beyond horrific. Everything crossed.

Canada has limited non-essential travel to the Northern Territories. In a passionate speech Prime Minister Justin Trudeau said:
"We need to keep following the recommendations of our public health agencies, and limit travel as much as possible... in times of need our strength is defined by how we care for each other, as neighbours, as communities, as a country." Canada now have 1563 cases and 21 losses of life

Australia and New Zealand’s borders are shut to anyone who is not a citizen or resident. Indoor gatherings of 100 or more are banned, outdoors gatherings over 500 people are banned.
“At no time in New Zealand’s history has a power like this been used, and I recognise how extraordinary it is,” said prime minister, Jacinda Ardern.
From midday Monday restaurants, cinemas and places of communal worship will close.

The UAE has closed parks and beaches.

The Lebanon has gone on lockdown and called in the military to enforce it.

Dubai will close all restaurants, cafes, coffee shops and food service establishments for two weeks from today to combat the spread of the coronavirus.

Donald Trump has written to North Korean leader, Kim Jong-un, offering help against coronavirus. North Korea have reported no cases of coronavirus and claim they have escaped the pandemic, although rumours aren't so positive. They have thanked him for his offer.

There will be a complete lockdown in 80 different Indian cities, including Delhi. Chief Minister Arvind Kejriwal announced:
"For your health, for Delhi and for the nation, we have decided to lock down the national capital from 6am on Monday till March 31 midnight. Extraordinary times require extraordinary measures."
1. State borders are closed
2. All shops, offices, factories, workplaces closed.
3. Public transport and construction suspended.
4. No international flights, interstate trains or other transport.
5. Religious buildings closed.

The Netherlands are saving extra lives by estimating burden on health care in specific hotspots, and relocating COVID-19 and other patients to other areas before ICU's begin to struggle. It sounds so simple, but the logistics are actually really awkward, especially during a Pandemic.

FACTS beat fear WHO advice

Whole World News: 

Your main job right now is to close your door, stay home, read books, play games and watch mindless garbage on TV. The public should not engage in the following:
Chainsaw juggling.
DIY using power tools you only use once a year. Or sharp non-powered tools you don't know the name of.
Running down stairs.
Leaving the tea towel on top of the stove/hob.
Running with scissors.
Going in the loft/attic without someone footing the ladder (bonus: soft landing if you slip).
Getting absolutely bladdered.
Fancy knife manoeuvres in the kitchen (just eat that avocado with a spoon).
Forgetting whether or not you took your tablets.
Anything stupid which might leave you needing hospital attention.

International travel is beginning to shut down as countries realise they have no choice. They need to close borders if they want to prevent imported cases. Most of Europe is already barred from a huge number of countries.
Some ships and boats are having to return to their country of registration as they struggle to get anyone else to take them.
Airports are beginning to suspend all flights and service.

At some point sensationalist media is going to point out that of all of the cases of COVID-19 with an outcome, 88% have recovered, and 12% have died. Before you panic, consider these points:
1. Some countries are rubbish at reporting recovered patients, but we always hear about patients who succumb very quickly.
2. When COVID-19 overwhelms a person, they can be lost within hours or days. The longest I'm aware of anyone spending in hospital before they went home fit and well, is almost 7 weeks. It's only 4 weeks since Italy suddenly had a massive problem.
3. There will be hundreds of thousands of people who aren't counted because they didn't end up in hospital. All over the world. Asymptomatic cases (no symptoms), people who thought they had a cold, people who were misdiagnosed because their country didn't realise they had any cases, people who couldn't get a test because they didn't fit criteria. There could be millions of them by the end of this pandemic.

We are yet again being warned about young patients who develop severe pneumonia very quickly, this time by American medics in New Orleans. Around 1/3 of the patients in ICU are younger than 60 without pre-existing conditions reports ProPublica and an unnamed respiratory therapist
"This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”
 “In my experience, this severity of ARDS is usually more typical of someone who has a near drowning experience — they have a bunch of dirty water in their lungs — or people who inhale caustic gas. Especially for it to have such an acute onset like that. I’ve never seen a microorganism or an infectious process cause such acute damage to the lungs so rapidly. That was what really shocked me.”

South Korean Coronavirus confirmed cases in S.Korea by age (Mar 22)
Over 80s : 392(4.41%)
70-79 : 595(6.69%)
60-69 : 1,132(12.72%)
50-59 : 1,691(19.01%)
40-49 : 1,221(13.72%)
30-39 : 909(10.22%)
20-29 : 2,396(26.93%)
10-19 : 460(5.17%)
0-9 : 101(1.14%)
Total : 8,897
(A huge percentage of South Korea's cases are from a Christian church group mainly comprised of young healthy adults who don't yet have families).

People of Iceland, thank you, and more specifically Icelandic medical research company deCode Genetics. They've offered everyone in the tiny population of just 364,000 people a test. So far they've tested 3,787 people and found 218 positives. Half of those positives have no symptoms.

At today's WHO press conference they unveiled an association with FIFA - Kick Out Coronavirus. Using footballers from around the world to demonstrate how we can help protect ourselves from coronavirus.

Famous People With COVID-19:
Juventus and Argentina forward Paulo Dybala
Former Italy captain Paolo Maldini
Michael Rosen???
Ex-film producer and inmate Harvey Weinstein

Lost their fight:
Former Real Madrid president Lorenzo Sanz

Sad and entirely predictable news today for anyone who has spent 4 years training for an international sports event. Dick Pound of the IOC has announced the Olympic Games have been be postponed, and the Japanese Government seem to agree. "Cancellation is not on the agenda".

Social Distancing = distancing yourself from society. No clubs, pubs, football matches or coffee mornings.
Physical Distancing = distancing yourself from other people so that you cannot transfer virus from one person to another.
Self-Isolating = keeping yourself away from other people, either for your own good or theirs.
Quarantine = keeping yourself away from other people while you ensure you are not carrying disease and won't infect them.
Lockdown = enforced isolation or restricted movement to regain control of a situation.

Joe Newman, a 107 year old man who survived the Spanish Flu pandemic 100 years ago gave some wise advice to an interviewer from NBC:
“You might say we’re all cripples in this thing and we all need a crutch. You have to be my crutch. I have to be yours. It’s been that way through every crisis we’ve had and then we find that’s what got us through.”

A pre-print study has found "Hydroxychloroquine is significantly associated with viral load reduction/disappearance in patients with COVID-19 and its effect is reinforced by Azithromycin."
Meaning Hydroxychloroquine and Azithromycin together do look like a promising treatment for COVID-19.  More research is currently taking place.

I often mention medical staff and NHS workers, but Pharmacists are absolutely rushed off their feet too, risking their families to save yours. One of them shared an image with me, so shared it here. To every essential worker out there making our world turn. Thank you. Excuse the swear

You can save the world. Don't mess it up

On Friday, the World Health Organization (WHO) launched SOLIDARITY - a mega-trial of 4 of the most promising drugs in the fight against COVID-19. Lots of theories and potentials for using currently available drugs exist. WHO is focusing on antiviral compound remdesivir, malaria medications chloroquine and hydroxychloroquine, a combination of HIV drugs lopinavir and ritonavir, and that same combination plus interferon-beta.

The Financial Times have created a fantastic stats tracker comparing different countries. Fantastic yet entirely horrifying. Best news is, it's not behind a paywall. There's a link in sources.

Figures released by China show more than 43,000 people had tested positive for Covid-19 by the end of February but had no immediate symptoms (asymptomatic). They were quarantined and monitored, but (against WHO guidelines) not included in the official report of confirmed cases, which was around 80,000 at that point. This clearly shows that around 1/3 of their positive cases didn't have any symptoms, and we know that there will be even more who were never tested.
Previously when WHO sent a team into China they only believed 2-3% of patients were asymptomatic. This Chinese evidence, along with news from Iceland, and Vo in France a few days ago, is really excellent in relation to the total amount of people who will need hospital care, and lives that will be lost, but it does mean it is super hard to find everyone with COVID-19 and prevent them spreading it.

When we breathe we exhale tiny droplets of moisture - you can see our breath when we breathe out on a very cold day. The coronavirus is so tiny and light that it can hitch a ride on these droplets. Physically distancing yourself from other people prevents you from breathing each other's air, but you have to be at least 6ft away, and about 8 feet / 2 metres when they sneeze or cough. If you could see inside the lungs of an infected person, you really wouldn't want to stand any closer.

The New York Times have put together a beautiful and haunting collection of photos called The Great Empty. The whole world is in this together.

Country / Cases / Losses of life
China 81,093 (+39) 3,270 (+9)
Italy 63,927 (+4,789) 6,077 (+601)
USA 41,569 (+8,023) 504 (+85)
Spain 33,089 (+4,321) 2,207 (+435)
Germany 28,865 (+3,992) 118 (+24)
Iran 23,049 (+1,411) 1,812 (+127)
France 19,856 (+3,838) 860 (+186)
S. Korea 8,961 (+64) 111 (+7)
Switzerland 8,547 (+1,073) 118 (+20)
Netherlands 4,749 (+545) 213 (+34)
Brazil 1,629 (+83) 25
Hong Kong 356 (+38) 4
Latvia 180 (+41)
Nigeria 36 (+6) 1 (+1)



Sources:

FT Tracker - https://www.ft.com/coronavirus-latest

Worldometer Coronavirus Tracker

https://www.nbc-2.com/story/41922922/survivor-of-spanish-flu-epidemic-great-depression-look-at-each-other-for-hope
https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments
https://amp.scmp.com/news/china/society/article/3076323/third-coronavirus-cases-may-be-silent-carriers-classified?__twitter_impression=true
https://www.politico.com/interactives/2020/coronavirus-testing-by-state-chart-of-new-cases/
https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients
https://twitter.com/jankluytmans/status/1241817677359976449?s=19
https://www.indiatoday.in/india/story/coronavirus-cm-kejriwal-announces-complete-lockdown-in-delhi-from-6-am-on-monday-1658484-2020-03-22
https://www.gov.uk/government/news/new-technology-challenge-to-support-people-who-are-isolating
https://twitter.com/Herman_Cro/status/1241608981208010752?s=19
https://www.medrxiv.org/content/10.1101/2020.03.16.20037135v1
https://twitter.com/hohocho/status/1241546833706364928?s=19
https://twitter.com/addicted2newz/status/1241398096451588096?s=19
https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
https://grapevine.is/news/2020/03/09/covid-19-in-iceland-decode-genetics-will-screen-general-population-for-virus/
https://www.bbc.co.uk/news/uk-52000150
https://www.thejakartapost.com/news/2020/03/22/covid-19-inadequate-medical-supplies-take-toll-on-lives-of-indonesian-medical-workers.html
https://www.ndtv.com/india-news/coronavirus-covid-19-80-cities-across-india-go-into-lockdown-till-march-31-what-it-means-2198894

https://twitter.com/MichaelRosenYes/status/1241620224752988160?s=19

"Day 7: Can’t stop my thermostat from crashing: icy hands, hot head. Freezing cold sweats. Under the covers for bed-breaking shakes. Image of war hero biting on a hankie, while best mate plunges live charcoal into the wound to cauterise it. Emerge as dawn breaks over grape stalks." Michael Rosen.




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